Manage the full credentialing lifecycle for physicians, NPs, and PAs — including Medicaid, Medicare, and commercial payer enrollments (Empire BCBS, Fidelis, Aetna, etc.). Review and verify provider documents such as medical licenses, DEA, board certifications, malpractice coverage, and CVs.
Numbers & Facts
Location
Long Island
Description
Key Responsibilities
Manage the full credentialing lifecycle for physicians, NPs, and PAs — including Medicaid, Medicare, and commercial payer enrollments (Empire BCBS, Fidelis, Aetna, etc.).
Review and verify provider documents such as medical licenses, DEA, board certifications, malpractice coverage, and CVs.
Prepare, track, and submit enrollment applications accurately and within payer timelines.
Monitor revalidation and re-credentialing schedules to ensure ongoing compliance.
Serve as the primary point of contact for escalated payer or provider inquiries.
Partner with internal billing and operations teams to ensure credentialing aligns with billing readiness.
Maintain credentialing logs, dashboards, and internal trackers for reporting purposes.
Assist in training and supporting new credentialing specialists, ensuring quality and consistency across workflows.
Qualifications
3+ years of healthcare credentialing experience; dermatology or multispecialty experience preferred.
Strong knowledge of CAQH, NPPES, Medicaid, Medicare, and commercial payer portals.
Exceptional attention to detail, organization, and follow-through.
Excellent communication and interpersonal skills.
Proficiency in Excel and credentialing systems; experience with eClinicalWorks a plus.